Published 2:19 pm, Thursday, July 28, 2016

In “Yale-led study finds reduced hospital admissions may lower readmission rates,” published on July 7, the conclusions reached need clarification.

It is true that many people who formerly would be admitted to the hospital are now being treated as out-patients. They are getting X-rays and MRIs and are seeing a multitude of specialists.

But this move to out-patient care strains the medical workforce. All specialties feel the pressure, but primary care physicians are markedly affected because they are seeing sicker patients with multiple problems than ever before. The elderly in particular have many chronic problems. Coordinating their care can be very difficult.

It is ironic that as hospital admissions decrease, primary care doctors’ work has increased and they have less time to spend with their patients. The point is that there are not enough primary care doctors around to do a good job.

Nurse practitioners in Connecticut (as in many other states) have been granted the right to practice independently. Many of them will practice alongside a primary care doctor but some will practice independently.

Though this idea is opposed by some doctors, nurse practitioners have been endorsed by the Institute of Medicine to practice within the limits of their training and education.

Without having access to a primary care doctor or a nurse practitioner, many patients go to the emergency room or to urgent care centers. Though the care they receive there is adequate, it cannot replace an ongoing relationship with someone that sees them on a regular basis.